Provider Demographics
NPI:1669990131
Name:CRANDALL, BROOKE ANNE (DC)
Entity type:Individual
Prefix:DR
First Name:BROOKE
Middle Name:ANNE
Last Name:CRANDALL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18320 FARMINGTON RD
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-3230
Mailing Address - Country:US
Mailing Address - Phone:248-893-7019
Mailing Address - Fax:734-943-6045
Practice Address - Street 1:18320 FARMINGTON RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-3230
Practice Address - Country:US
Practice Address - Phone:248-893-7019
Practice Address - Fax:734-943-6045
Is Sole Proprietor?:No
Enumeration Date:2017-09-06
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301010585111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor